Psychiatric mental health consultation and nursing in the United Arab Emirates.

1. Our "mission" was preparing psychiatric services for the anticipated high number of allied casualties; providing clinical, educational, and developmental support to the host nation; and maintaining diplomatic relations within the hospital and surrounding community. 2. Because of cultural differences, the hospital staff were uneasy about some of the inservice classes. US staff were taught the importance of refusing to succumb to "the illusion of color blindness." 3. With the support of the host, we took leadership in receiving and training the casualties of the war. Psychiatric services were provided to allied troops as well as the citizens of Dubai.     

Spirituality, meaning, mental health, and nursing

1. Spirituality, defined as meaning making, is a primary motivation in life. 2. The medical literature increasingly demonstrates an important positive relationship between spirituality and health. 3. Nurses often feel uncomfortable or unprepared to discuss spiritual issues with patients. 4. Through a few simple questions, nurses can easily make spiritual assessment a routine part of taking a patient's psychosocial history.     

Learning opportunities through camping for mental health nursing

1. To equip nurses with the skills necessary for working with disturbed people, nurse educators need to be mindful of not watering down the essential skills necessary for nurses to deal with difficult behaviour in all branches of nursing. 2. These components of a mental health clinical experience should equip the graduate to deal with the pressures of dealing with disturbed people in any environment, as the skills learned generalize to any branch of nursing. 3. Universities can combine with traditional hospital services and community mental health services to provide services to clients with mental illness. An additional benefit is in providing students with an intensive clinical learning experience that reinforces the theory taught in the classroom.     

Providing nursing leadership in a community residential mental health setting

The worldwide burden of mental illness is increasing. Strong leadership is increasingly emerging as a core component of good mental health nursing. The aim of this article is to demonstrate the ways in which nurses can provide strong and consistent leadership in a values-based practice environment that embodies respect for individuals' dignity and self-determination within a community residential mental health service, which provides a structural foundation for effective action. This is accomplished through the presentation of two vignettes, which highlight how the seemingly impossible becomes possible when an economic paradigm such as agency theory is exchanged for a sociological and psychological paradigm found in leadership as stewardship at the point of service. It is through stronger nursing leadership in mental health that stigma and discrimination can be reduced and better access to treatments and services can be gained by those with mental illness. Nurse leadership in mental health services is not new, but it is still relatively uncommon to see residential services for "high needs" individuals being led by nurses. How nurses meet the challenges faced by mental health services are often at the heart of effective leadership skills and strategies.     

Issues in mental health care benefits: the costs of mental health parity

This Issue Brief discusses issues in mental health care benefits. It describes the current state of employment-based mental health benefits and discusses studies and issues regarding full mental health parity. It also includes an analysis of the effect of full mental parity on the uninsured population and the effects of the limited mental health parity provision contained in the VA-HUD appropriations bill. The final section discusses the implications of mental health parity for health plans and health insurers. When employers began to provide health insurance benefits to their employees and their families, they extended coverage to include mental health benefits under the same terms as other health care services. Many employers continued to add mental health benefits through the 1970s and early 1980s until cost pressures required employers to re-examine all health care benefits that were offered. They quickly found that, while only a small proportion of the beneficiaries used mental health care services, the costs associated with this care were very high. As a result, employers placed limits on mental health benefits in an attempt to make the insurance risk more manageable. The general strategies employers have used to manage their health care costs are cost sharing, utilization review, managed care, and the packaging of provider services. Employers' cost management strategies may be restricted, however. Five states have mental health parity laws, but three of the states--Rhode Island, Maine, and New Hampshire--apply these laws only to the seriously mentally ill. In addition, 31 states mandate that mental health benefits be provided. However, state mandates apply only to insured plans, not to self-insured employer plans, which are exempt from state regulation of health plans under the Employee Retirement Income Security Act of 1974 (ERISA). A number of recent studies have examined the effect of mental health parity on health insurance premiums in a "typical" preferred provider organization and on the uninsured. In general, the studies concluded that mental health parity could increase health insurance premiums, decrease health insurance coverage for non-mental health related illnesses, and increase the number of uninsured individuals. All studies of mental health parity, and mandated benefits in general, assume that there is a strong likelihood that increased health benefit costs would be passed along to workers in the form of higher cost sharing for health insurance, lower wage growth, or lower growth in other employee benefits.     

The mental health of the never-married

Although the interaction between mental health and marital status has been the object of much social scientific research, little is known about the mental health of never-married people. This article reviews research relevant to mental health and marital status as it pertains to never-marrieds. Methodological problems and current gaps in such research are pointed out. The mental health of never-marrieds is examined from three popular models of mental health—the social protection, social reaction, and social selection models. Each model offers competing explanations for differences in rates between married and unmarried people and between unmarried men and women. Suggestions are offered for improvement in researching the mental health of this neglected group.